Provider Demographics
NPI:1265906903
Name:LATTIERI, CHELSEA MARIE (NP-C)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:MARIE
Last Name:LATTIERI
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:MARIE
Other - Last Name:LARET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 967
Mailing Address - Street 2:
Mailing Address - City:DUNCANSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16635-0967
Mailing Address - Country:US
Mailing Address - Phone:814-940-0407
Mailing Address - Fax:
Practice Address - Street 1:1894 PLANK RD
Practice Address - Street 2:
Practice Address - City:DUNCANSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16635-8380
Practice Address - Country:US
Practice Address - Phone:814-940-0407
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-16
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP019910363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology